IDEAS home Printed from https://ideas.repec.org/a/eee/chieco/v22y2011i3p428-439.html
   My bibliography  Save this article

The productive efficiency of Chinese hospitals

Author

Listed:
  • Ng, Ying Chu

Abstract

Since the implementation of health care reforms, much has been documented regarding the practices and behavior of hospitals or health profession in China. While these documentations pointed to various problems arising from the reforms, a systematic analysis is rarely found. Based on five years' data, the present study aims at providing empirical evidence of inefficiency of hospitals in China. Using the data envelopment analysis, the sources of inefficiency were examined. Echoing the unnecessary care, over-prescription of drugs and the adoption of high-tech treatments since the implementation of health care reforms, the sampled hospitals were found quite inefficient and pure technical inefficiency played a dominant role in driving the inefficiency of hospitals. Combining the panel nature of the data and the Malmquist Index computation, hospitals had experienced productivity growth between 2004 and 2008. Mirroring the behavior of hospitals, technological progress was the underlying force for the growth and the deterioration in efficiency change was found. The results summarized by region revealed that the stage of economic development and the efficiency performance of hospital did not necessarily go hand in hand.

Suggested Citation

  • Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, vol. 22(3), pages 428-439, September.
  • Handle: RePEc:eee:chieco:v:22:y:2011:i:3:p:428-439
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S1043951X11000460
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. David M. Cutler & Ernst R. Berndt, 2001. "Introduction to "Medical Care Output and Productivity"," NBER Chapters, in: Medical Care Output and Productivity, pages 1-12, National Bureau of Economic Research, Inc.
    2. Gary Ferrier & Michael Rosko & Vivian Valdmanis, 2006. "Analysis of uncompensated hospital care using a DEA model of output congestion," Health Care Management Science, Springer, vol. 9(2), pages 181-188, May.
    3. Anatoly I. Pilyavsky & William E. Aaronson & Patrick M. Bernet & Michael D. Rosko & Vivian G. Valdmanis & Mikhail V. Golubchikov, 2006. "East–west: does it make a difference to hospital efficiencies in Ukraine?," Health Economics, John Wiley & Sons, Ltd., vol. 15(11), pages 1173-1186, November.
    4. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    5. Eggleston, Karen & Wang, Jian & Rao, Keqin, 2008. "From plan to market in the health sector?: China's experience," Journal of Asian Economics, Elsevier, vol. 19(5-6), pages 400-412.
    6. Dino Rizzi & Vincenzo Rebba, 2006. "Measuring Hospital Efficiency through Data Envelopment Analysis when Policy-makers� Preferences Matter. An Application to a sample of Italian NHS hospitals," Working Papers 2006_13, Department of Economics, University of Venice "Ca' Foscari".
    7. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    8. Karen Eggleston & Winnie Yip, 2004. "Hospital Competition under Regulated Prices: Application to Urban Health Sector Reforms in China," International Journal of Health Economics and Management, Springer, vol. 4(4), pages 343-368, December.
    9. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    10. Liu, Xingzhu & Mills, Anne, 2002. "Financing reforms of public health services in China: lessons for other nations," Social Science & Medicine, Elsevier, vol. 54(11), pages 1691-1698, June.
    11. Caves, Douglas W & Christensen, Laurits R & Diewert, W Erwin, 1982. "The Economic Theory of Index Numbers and the Measurement of Input, Output, and Productivity," Econometrica, Econometric Society, vol. 50(6), pages 1393-1414, November.
    12. Nikolaos Maniadakis & Emmanuel Thanassoulis, 2000. "Assessing productivity changes in UK hospitals reflecting technology and input prices," Applied Economics, Taylor & Francis Journals, vol. 32(12), pages 1575-1589.
    13. Chang, Hsihui & Cheng, Mei-Ai & Das, Somnath, 2004. "Hospital ownership and operating efficiency: Evidence from Taiwan," European Journal of Operational Research, Elsevier, vol. 159(2), pages 513-527, December.
    14. Gian Paolo Barbetta & Gilberto Turati & Angelo M. Zago, 2007. "Behavioral differences between public and private not‐for‐profit hospitals in the Italian national health service," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 75-96, January.
    15. Meng, Qingyue & Rehnberg, Clas & Zhuang, Ning & Bian, Ying & Tomson, Goran & Tang, Shenglan, 2004. "The impact of urban health insurance reform on hospital charges: a case study from two cities in China," Health Policy, Elsevier, vol. 68(2), pages 197-209, May.
    16. H. Brown & José Pagán, 2006. "Managed care and the scale efficiency of US hospitals," International Journal of Health Economics and Management, Springer, vol. 6(4), pages 278-289, December.
    17. E Zere & Diane Mcintyre & T Addison, 2001. "Technical Efficiency And Productivity Of Public Sector Hospitals In Three South African Provinces," South African Journal of Economics, Economic Society of South Africa, vol. 69(2), pages 336-358, June.
    18. Chen, Andrew & Hwang, Yuhchang & Shao, Benjamin, 2005. "Measurement and sources of overall and input inefficiencies: Evidences and implications in hospital services," European Journal of Operational Research, Elsevier, vol. 161(2), pages 447-468, March.
    19. Richard Herd & Yu-Wei Hu & Vincent Koen, 2010. "Improving China's Health Care System," OECD Economics Department Working Papers 751, OECD Publishing.
    20. Karen Eggleston & Li Ling & Meng Qingyue & Magnus Lindelow & Adam Wagstaff, 2008. "Health service delivery in China: a literature review," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 149-165, February.
    21. Fare, Rolf & Grosskopf, Shawna & Yaisawarng, Suthathip & Li, Sung Ko & Wang, Zhaoping, 1990. "Productivity growth in Illinois electric utilities," Resources and Energy, Elsevier, vol. 12(4), pages 383-398, December.
    22. Margit Sommersguter-Reichmann, 2000. "The impact of the Austrian hospital financing reform on hospital productivity: empirical evidence on efficiency and technology changes using a non-parametric input-based Malmquist approach," Health Care Management Science, Springer, vol. 3(4), pages 309-321, September.
    23. David M. Cutler & Ernst R. Berndt, 2001. "Medical Care Output and Productivity," NBER Books, National Bureau of Economic Research, Inc, number cutl01-1, June.
    24. Jens Leth Hougaard & Lars Peter Østerdal & Yi Yu, 2008. "The Chinese Health Care System: Structure, Problems and Challenges," Discussion Papers 08-01, University of Copenhagen. Department of Economics.
    25. L. Steinmann & P. Zweifel, 2003. "On the (in)efficiency of Swiss hospitals," Applied Economics, Taylor & Francis Journals, vol. 35(3), pages 361-370.
    26. Lukas Steinmann & Gunnar Dittrich & Alexander Karmann & Peter Zweifel, 2004. "Measuring and comparing the (in)efficiency of German and Swiss hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(3), pages 216-226, September.
    27. Brenda Gannon, 2005. "Testing for Variation in Technical Efficiency of Hospitals in Ireland," The Economic and Social Review, Economic and Social Studies, vol. 36(3), pages 273-294.
    28. Emrouznejad, Ali & Parker, Barnett R. & Tavares, Gabriel, 2008. "Evaluation of research in efficiency and productivity: A survey and analysis of the first 30 years of scholarly literature in DEA," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 151-157, September.
    29. Matthias Staat, 2006. "Efficiency of hospitals in Germany: a DEA-bootstrap approach," Applied Economics, Taylor & Francis Journals, vol. 38(19), pages 2255-2263.
    30. Rolf Färe & Shawna Grosskopf & William L. Weber, 1989. "Measuring School District Performance," Public Finance Review, , vol. 17(4), pages 409-428, October.
    31. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 7-23, July.
    32. Gillian McCallion & J. Colin Glass & Robert Jackson & Christine Kerr & Donal McKillop, 2000. "Investigating productivity change and hospital size: a nonparametric frontier approach," Applied Economics, Taylor & Francis Journals, vol. 32(2), pages 161-174.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Alexander Karmann & Felix Roesel, 2017. "Hospital Policy and Productivity – Evidence from German States," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1548-1565, December.
    2. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    3. You, Jing, 2013. "The role of microcredit in older children’s nutrition: Quasi-experimental evidence from rural China," Food Policy, Elsevier, vol. 43(C), pages 167-179.
    4. Xueli Chen & Vivian Valdmanis & Tuotuo Yu, 2020. "Productivity Growth in Chinese Medical Institutions during 2009–2018," Sustainability, MDPI, Open Access Journal, vol. 12(8), pages 1-17, April.
    5. Sami Chaabouni & Chokri Abednnadher, 2016. "Cost Efficiency of Tunisian Public Hospitals: a Bayesian Comparison of Random and Fixed Frontier Models," Journal of the Knowledge Economy, Springer;Portland International Center for Management of Engineering and Technology (PICMET), vol. 7(3), pages 771-781, September.
    6. Antonio José Orozco-Gallo, 2017. "Una aproximación regional a la eficiencia y productividad de los hospitales públicos colombianos," Chapters, in: Jaime Bonet & Karelys Guzmán-Finol & Lucas Wilfried Hahn-De-Castro (ed.),La salud en Colombia: una perspectiva regional, chapter 6, pages 173-209, Banco de la Republica de Colombia.
    7. Minghong Tan, 2014. "The Transition of Farmland Production Functions in Metropolitan Areas in China," Sustainability, MDPI, Open Access Journal, vol. 6(7), pages 1-14, June.
    8. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    9. Yongjin Li & David López-Carr & Wenjiang Chen, 2014. "Factors Affecting Migration Intentions in Ecological Restoration Areas and Their Implications for the Sustainability of Ecological Migration Policy in Arid Northwest China," Sustainability, MDPI, Open Access Journal, vol. 6(12), pages 1-22, November.
    10. Bolan Liu & Xiaowei Ai & Pan Liu & Chuang Zhang & Xingqi Hu & Tianpu Dong, 2015. "Fuel Economy Improvement of a Heavy-Duty Powertrain by Using Hardware-in-Loop Simulation and Calibration," Energies, MDPI, Open Access Journal, vol. 8(9), pages 1-14, September.
    11. Boussemart, Jean-Philippe & Ferrier, Gary D. & Leleu, Hervé & Shen, Zhiyang, 2020. "An expanded decomposition of the Luenberger productivity indicator with an application to the Chinese healthcare sector," Omega, Elsevier, vol. 91(C).
    12. Yaisawarng, Suthathip & Ng, Ying Chu, 2014. "The impact of higher education reform on research performance of Chinese universities," China Economic Review, Elsevier, vol. 31(C), pages 94-105.
    13. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    14. Simar, Léopold & W. Wilson, Paul, 2019. "Central limit theorems and inference for sources of productivity change measured by nonparametric Malmquist indices," European Journal of Operational Research, Elsevier, vol. 277(2), pages 756-769.
    15. Jian Chai & Youhong Zhou & Ting Liang & Limin Xing & Kin Keung Lai, 2016. "Impact of International Oil Price on Energy Conservation and Emission Reduction in China," Sustainability, MDPI, Open Access Journal, vol. 8(6), pages 1-17, May.
    16. Bo Hsiao & Li-Hsueh Chen, 2019. "Performance Evaluation for Taiwanese Hospitals by Multi-Activity Network Data Envelopment Analysis," International Journal of Information Technology & Decision Making (IJITDM), World Scientific Publishing Co. Pte. Ltd., vol. 18(03), pages 1009-1043, May.
    17. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    18. Cláudia Araújo & Carlos Barros & Peter Wanke, 2014. "Efficiency determinants and capacity issues in Brazilian for-profit hospitals," Health Care Management Science, Springer, vol. 17(2), pages 126-138, June.
    19. Jing You, 2016. "Lending to Parents and Insuring Children: Is There a Role for Microcredit in Complementing Health Insurance in Rural China?," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 543-558, May.
    20. Ho, Foo Nin & Huang, Chin-wei, 2020. "The interdependencies of marketing capabilities and operations efficiency in hospitals," Journal of Business Research, Elsevier, vol. 113(C), pages 337-347.
    21. Akkan, Can & Karadayi, Melis Almula & Ekinci, Yeliz & Ülengin, Füsun & Uray, Nimet & Karaosmanoğlu, Elif, 2020. "Efficiency analysis of emergency departments in metropolitan areas," Socio-Economic Planning Sciences, Elsevier, vol. 69(C).
    22. Karelys Guzmán-Finol, 2017. "¿Qué hay detrás de un cambio en la productividad hospitalaria?," Chapters, in: Jaime Bonet & Karelys Guzmán-Finol & Lucas Wilfried Hahn-De-Castro (ed.),La salud en Colombia: una perspectiva regional, chapter 7, pages 211-247, Banco de la Republica de Colombia.
    23. Yang, Jinqiu & Zeng, Wu, 2014. "The trade-offs between efficiency and quality in the hospital production: Some evidence from Shenzhen, China," China Economic Review, Elsevier, vol. 31(C), pages 166-184.
    24. Kejia Chu & Ning Zhang & Zhongfei Chen, 2015. "The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia," Sustainability, MDPI, Open Access Journal, vol. 7(10), pages 1-20, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:chieco:v:22:y:2011:i:3:p:428-439. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Haili He). General contact details of provider: http://www.elsevier.com/locate/chieco .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.